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A multinational, double-blind, parallel-group study assessed the safety and efficacy of dose-adjusted sitagliptin in patients with type 2 diabetes and moderate or severe chronic kidney disease. Patients were randomized to a 12-week therapy with oral sitagliptin or placebo, and a 42-week continuation phase in which they were given sitagliptin or glipizide instead of placebo. The results from the first phase of the study revealed that HbA1c levels were significantly reduced in patients receiving sitagliptin (-0.6% vs. –0.2%); these beneficial effects were maintained during the remaining of the trial. No relevant differences among treatment arms were observed as regards drug-related mortality and serious adverse events, although the incidence of hypoglycemia was lower in patients receiving sitagliptin. Therefore, sitagliptin is well tolerated and provides effective glycemic control in patients with type 2 diabetes and renal impairment (Chan, J.C.N. et al. Diabetes Obes Metab 2008: 10(7): 545).